Sansosti Laura E, Crowell Amanda, Ellis-McConnell Whitney, Meyr Andrew J
J Am Podiatr Med Assoc. 2018 Mar;108(2):151-157. doi: 10.7547/16-094.
A patient "handoff," or the "sign-out" process, is an episode during which the responsibility of a patient transitions from one health-care provider to another. These are important events that affect patient safety, particularly because a significant proportion of adverse events have been associated with a relative lack of physician communication. The objective of this investigation was to survey podiatric surgical residency programs with respect to patient care handoff and sign-out practices.
A survey was initially developed and subsequently administered to the chief residents of 40 Council on Podiatric Medical Education-approved podiatric surgical residency programs attempting to elucidate patient care handoff protocols and procedures and on-call practices.
Although it was most common for patient care handoffs to occur in person (60.0%), programs also reported that handoffs regularly occurred by telephone (52.5%) and with no direct personal communication whatsoever other than the electronic passing of information (50.0%). In fact, 27.5% of programs reported that their most common means of patient care handoff was without direct resident communication and was instead purely electronic. We observed that few residents reported receiving formal education or assessment/feedback (17.5%) regarding their handoff proficiency, and only 5.0% of programs reported that attending physicians regularly took part in the handoff/sign-out process. Although most programs felt that their sign-out practices were safe and effective, 67.5% also believed that their process could be improved.
These results provide unique information on a potentially underappreciated aspect of podiatric medical education and might point to some common deficiencies regarding the development of interprofessional communication within our profession during residency training.
患者“交接”，即“交班”过程，是指患者的责任从一名医疗服务提供者转移至另一名医疗服务提供者的阶段。这些都是影响患者安全的重要事件，特别是因为相当一部分不良事件与医生沟通相对不足有关。本调查的目的是就患者护理交接和交班实践对足病外科住院医师培训项目进行调查。
最初设计了一项调查问卷，随后对40个经足病医学教育委员会批准的足病外科住院医师培训项目的总住院医师进行调查，试图阐明患者护理交接方案和程序以及值班实践情况。
虽然患者护理交接最常见的方式是面对面进行（60.0%），但各项目也报告称，交接也经常通过电话进行（52.5%），并且除了信息的电子传递外没有任何直接的个人沟通（50.0%）。事实上，27.5%的项目报告称，他们最常见的患者护理交接方式是没有住院医师直接沟通，而是完全电子化的。我们观察到，很少有住院医师报告接受过关于其交接熟练程度的正规教育或评估/反馈（17.5%），只有5.0%的项目报告称主治医生经常参与交接/交班过程。虽然大多数项目认为他们的交班实践是安全有效的，但67.5%的项目也认为他们的流程可以改进。
这些结果提供了关于足病医学教育中一个可能未得到充分重视的方面的独特信息，并可能指出在住院医师培训期间我们专业内部跨专业沟通发展方面的一些常见缺陷。
